Stabilisation of the fractured fibula plays an important role in the treatment of pilon fractures: a retrospective comparison of fibular fixation methods.
Ninety-eight pilon fractures associated with ipsilateral distal fibular fracture were included in this study. The pilon fractures were treated by open reduction and plating. The 98 fractures were divided into three groups based on the treatment method of fractured fibula. Group A was composed of 50 fibular fractures treated by open reduction and plate fixation. Group B was composed of 23 fibular fractures treated by open reduction and pin fixation. Group C was composed of 25 fibular fractures treated conservatively by closed reduction. The radiographs were reviewed for adequacy of fracture reduction and posttraumatic arthrosis. At the end of follow-up, the clinical outcomes were evaluated using a rating scale. The three groups were similar in respect to Ruedi type, open fracture grade, and demographics (all p values >0.25). Group A showed a decreasing trend of malunion and ankle arthrosis compared to group C (p = 0.091 and p = 0.099, respectively). Group A had a better clinical outcome than group C (p = 0.008). In addition, group A showed an increasing trend of satisfactory outcome compared to group B (p = 0.096). In conclusion, for pilon fractures associated with ipsilateral fibular fractures, stabilisation of the fractured fibula plays an important role in the decrease of distal tibial malunion and post-traumatic ankle arthrosis as well as improvement of clinical outcomes.
Lee
Yih-Shiunn
YS
Department of Orthopedic Surgery, Lin Shin Hospital, Taichung City, Taiwan.
Chen
Shu-Wen
SW
Chen
Shih-Hao
SH
Chen
Wen-Chiao
WC
Lau
Ming-Jye
MJ
Hsu
Tzu-Liang
TL
D000328:Adult; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005360:Fibula / Q000293:injuries / Q000601:surgery*; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D016896:Treatment Outcome